Son sick...minor tics

[susanna]

My son has been sick with a cold the past few days. His sniffling, due to his illness, is also accompanied by some facial tics which we haven't seen for months. I'm hoping once the cold goes away the facial tics will as well.

 

I've been giving him vitamin C. Also, would the zinc lozenges be helpful at this point? Anthing else I could try? My homeopathic dr. had previously mentioned some homeopathic remedies for the flu when we had discussed my not having my son get the flu shot this year...I also will check with her to see what she recommends for this cold.

 

He hasn't complained of a sore throat, but do you think I should have a strep throat culture done anyway? It seems that a strep infection last March is what started the whole ticcing thing for him.

 

I appreciate your feedback.

[Claire]

The zinc lozenges in the studies were given the first day of symptoms. Same with echinacea. I honestly don't know if they would help or not at this point, sorry! Others? I can't see them hurting, but it could be a waste of time.

 

 

Generally strep is not accompanied by cold symptoms. If no sore throat (or fever) I wouldn't worry.

 

Claire

 

Edited 10-24 I just read Ronna's post and will defer to her on symptoms.

[Ronnas]

Susanna,

 

Have you read much about PANDAS? If your son's tics began with a strep infection last March then he may be a child with PANDAS. We have found with our son that any infection (viral or bacterial) tends to set him off. I have read that once the immune system is primed to overreact it will. For example, one of my son's worst setbacks in the last few years was when he had the chicken pox.

 

Overall, it would not hurt to get a throat swab done if he has suddenly developed tics again. My son never had any classic symptoms of strep...we now believe he had strep in his sinuses...anyways, strep can present very differently from kid to kid. I think it is better to be safe and have the throat swab done. At one time we had the whole family swabbed...my youngest daughter had no symptoms and came back positive for strep...my second son had all the symptoms of strep and came back negative...go figure...

 

Ronna

[Heather]

Susanna,

 

My son's tics always became worse over the past year when he developed a virus. My naturopath prescribed an anti-viral homeopathic drop called pleo quente. We used this drop twice during viral infections and it seemed to help the tics subside quicker.

 

Heather

[susanna]

Thanks for the feedback.

 

My concern with the lozengses were that the ones I've seend contain echinacea and I believe I read somewhere that could be a no-no for certain kids...forget why but do rememver that my son fit into that no-no group.

 

Ronna, yes I have read up on PANDAS and I do believe that was the trigger for my sons tics. I think I am going to go ahead with the throat swab...it can't hurt.

 

Heather, I'll see what my homeopath has to suggest.

 

Thanks again all...I knew I could count on you for advice and info.

[Heather]

Susanna,

 

The echinacea concern was probably something that I posted. Echinacea is an immune booster so if your child does have PANDAS which is an autoimmune disorder, ehinacea could actually aggravate symptoms since it boosts the immune system to attack its own tissues in these individuals.

 

Echinacea had a bad effect on my son last winter and then I read that echinacea is a contraindication for people with autoimmune disorders.

 

Heather

[Claire]

Hi Heather,

 

I am not sure how I missed that post of yours--I thought I read them all. Since my son didn't have PANDAS maybe this is why he doesn't react. He only takes them for 3 days or so at the onset.

 

They do have zinc losenges without echinacea at whole foods.

 

Claire

[Andy]

It usually takes a week after my son has been sick to get the tics back under control and that is with his supplements which includes zinc on a daily basis. The best thing that works with us is sleep and time.

[susanna]

Update:

Well I took my son to the pediatrician's this afternoon. As luck would have it we saw the doctor that we saw when my son started ticcing. This is the doctor that told us to mention to the neuro that my son had recently had strep (although at the time he didn't tell me why that was important and I didn't know enough to question it) Although my son doesn't have the classic strep symptoms, he did a throat swab to appease me. Guess what, the rapid strep test came back positive! The doctor was floored, and quite honestly so was I....I really felt I was just being paranoid, but I guess not. So now my son is on a round of antibiotics (have to pick up more probiotics tomorrow) The dr. also gave my son a nebulizer treatment in the office and we are to continue that until his chest congestion clears up. He wants to see him in 2-3 weeks for a strep recheck. The dr. did mention something about my son being a possible carrier of strep. I didn't get into what that really means for my son with the dr. at this time, but will follow up when we go for our recheck as I will make sure the recheck appointment is with this dr. since he at least acknowledges PANDAS even exists. I thought it was interesting that he questioned me on what the neuro thought of the PANDAS theory (neuro doesn't really buy into it)

[Claire]

No way. Good for us to know! And good for you for pushing this!

 

Claire

 

ps, Glad I deferred to Ronnas on symptoms! After she posted I remember a friend's kids with strep, with no symptoms but a rash that disappeared.

[Chemar]

Susanna

 

at this point you should also maybe consider having a comprehensive blood test done for the full spectrum of strep types that can be implicated in PANDAs

 

My son was not PANDAs, but we spent a number of months seeing a great doctor who is at the forefront of PANDAs research, and we learned there that the only truly reliable tests for full spectrum strep is the blood test.

 

Hope your son is better soon

[Ronnas]

Susanna,

 

I am glad you went and had the strep test done. It is important for you to find a doctor knowledgeable about PANDAS. I think you have been very lucky to have evidence of a positive throat swab in relation to the tics.

 

I would contact the NIMH as they do have current research studies ongoing right now that your son may qualify for depending on where you live. I have corresponded with Dr. Swedo, and Dr. Garvey at the NIMH...as well as a few more doctors there and found them to be supportive and they absolutely wanted to help...I almost fell out of my chair the day Dr. Garvey phoned me.

 

Just look under "Current PANDAS research" to contact the PANDAS group at the NIMH.

 

http://intramural.nimh.nih.gov/research/pdn/web.htm

 

A thread I started on the "old braintalk" has alot of good information about PANDAS and would be a good place to start reading BEFORE you see your doctor again.

 

http://neuro-mancer.mgh.harvard.edu/ubb/Fo...TML/005700.html

 

Below is some information that I think is very important which I got from The Canadian Medical Association Journal...it is a very good and should be posted in every doctors office!

 

CMAJ November 13, 2001; 165(10) Is obsessive-compulsive disorder an autoimmune disease by, Paul D. Arnold and Margaret A. Richter.

 

http://www.cmaj.ca/cgi/content/full/165/10/1353

 

They have illustrated a diagnostic algorithm which is based on the literature summarized and their own clinical judgement which is as follows:

 

Preadolescent child with sudden onset or exacerbation of OCD symptoms or tics.

 

Screen for comorbid symptoms: separation anxiety, emotional lability, ADHD.

 

Take medical history, focusing on a history suggestive of streptococcal infection and neurological problems.

 

Perform mental status examination.

 

Perform focused physical examinaiton looking for signs of streptococcal infection and abnormal movements (e.g., tics, choreiform movements).

 

Take family history, screening for OCD or tic disorders as well as rheumatic fever or Sydenham's chorea.

 

Is there evidence of a streptococcal infection temporally associated with symptom onset or exacerbation? OR is there a strong family history of rheumatic fever?

 

NO: Initiate, augment or switch standard treatments (e.g., CBT or SRI's for OCD) according to established guidelines.

 

YES: Take a throat swab and send for culture. Perform ASO titer. (an ASO titer is recommended because an antiDNAse B titer is expensive and not widely available in Canada).

 

Is the throat swab positive?

 

NO: Initiate, augment or switch standard treatments according to established guidelines.

 

YES: Treat infection with antibiotics. (and initiate, augment or switch standard treatments according to established guidelines.

 

Monitor symptoms over time

 

Treat recurrent infections promptly with antibiotics

 

Repeat ASO titers (suggest every 3-4 weeks for an additional 1-2 titers) and observe trends.

 

Is there evidence of repeated exacerbations of symptoms associated with either increassed titers or clinical evidence of streptococcal infections?

 

NO: Initiate, augment or switch standard treatments according to established guidelines.

 

YES: Consider switching or augmenting initial psychotropic medications.

 

Consider antibiotic prophylaxis in consultation with a pediatrician

 

Consult with a child psychiatrist or neurologist or refer to the NIMH PANDAS study.

 

 

 

I hope your son shows some improvement with the antibiotics.

 

Take Care,

Ronna

[Claire]

Susanna,

 

By the way, zinc is critical in keeping infections down.

 

Does your son have white spots on his fingernails? This is just one indicator of a zinc deficiency.

 

This is independent of treating strep properly, but it could make him less susceptible.

 

I am speaking of zinc capsules (best taken at bedtime). This is different from a zinc lozenge the first day of a cold.

 

Claire

 

ps Ronna--great input on this for Susanna to test even without classic symptoms!

[susanna]

Thanks for the great info Ronnas. I will definitely make a point of contacting the NIMH this week and reading up on the info you posted. I had read your post in Braintalk but will go back and take another look.

 

His facial tics are already improving. They weren't "awful" to begin with, I was just concerned because tics of any kind reappeared. It's actually sort of a relief to find out the strep was causing the tics...at least I have a clear-cut trigger and will know what to look for next time.

 

I am having an awful time getting the antibiotic in him. It's augmentin and he hates it...this is a child who has always been a trooper about taking meds. I'll have to remember to ask the ped for something else next time he needs an antibiotic. Any tips or tricks to get him to take this? We've tried a number of things to no avail.

 

Claire, my son does not have white spots on his fingernails. I still haven't had my follow up appointment with our homeopathic pediatrician where we will discuss supplementation and further testing. That should be happening within the next month or so.

 

Thank you all again!

[Frank_Sm1th]

All of this makes me think about the winter cold season coming up. We don't give our son (w/PANDAS) echinacea because everyone says it's an "immune booster". But I wonder if golden seal's ok? Or astragalus? I'm not sure golden seal even affects the immune system; I take it for its effect of drying me up when I have the sniffles, much as an OTC antihistamine would. And I'm not sure if astragalus is a "booster" or a "balancer" or what.

 

Any thoughts, observations, opinions anyone?

 

Frank